Bills have stalled amid growing public scorn over costs and political deal making, but many agree need for reform is still there.

President Obama’s health reform plan hasn’t stalled just because of one election in Massachusetts. The seeds for today’s impasse were planted long ago.

Early on, the president and Democratic leaders in Congress made a strategic decision to keep the for-profit, private health insurance industry at the heart of our system. In doing so, they precluded any chance of achieving a reform that was truly universal, comprehensive and affordable. It’s that simple.

Now, after months of watching the Democrats’ sordid deal-making with the big insurers and drug companies, and after getting a glimpse of some of the legislation’s deep flaws, the public’s support for the process has plummeted and the bills have stalled.

But the need for reform – for meeting the health care needs of the U.S. people – has never been more urgent, especially in view of our dire economic straits.

Some say the Senate health bill should be passed and then cleaned up later. But both the Senate and House bills would keep the for-profit private insurers – who cause us to spend about 31 cents of every health care dollar on administration, most of it on wasteful paperwork and bureaucracy – firmly in the driver’s seat. That’s a prescription for failure.

Others suggest a scaled-back reform, partial measures. But many of these proposals are deeply regressive, like making cuts to traditional Medicare to subsidize the purchase of private health insurance. (On the other hand, government steps like spending more money on community health centers or the primary care infrastructure would certainly help in the short term.)

But a recent CNN/Opinion Research survey shows about half the public would like to see our lawmakers start over. Doing so is not as implausible as it may first seem.

President Obama himself, in his State of the Union message, said if someone has a better idea, “Let me know. I’m eager to see it.”

Mr. President, we should start with a system that we know works well, is cost-efficient and could quickly be extended to cover everybody in the country – Medicare. Medicare presently covers 45 million people, mainly those over 65 and the totally disabled, but it could be improved upon and extended to people of all ages with relative ease.

Doing so would yield about $400 billion in annual savings from the reduced administrative costs in our system, thereby allowing us to give everyone comprehensive, high-quality coverage with no co-pays or deductibles.

A single-payer Medicare-for-All system would also give us cost-control tools like bulk purchasing, negotiated fees and capital investment planning, thereby providing a secure financial foundation for future generations, too.

Surveys show about two-thirds of the U.S. population support such an approach, and a recent study in the Annals of Internal Medicine showed that 59 percent of physicians want government action to establish national health insurance.

Dr. William Hsiao, a Harvard economist who has assisted several other nations in their health system reforms, recently said, “You can have universal coverage and good quality health care while still managing to control costs. But you have to have a single-payer system to do it.”

The remedy is clear. It’s time to drive that point home with our lawmakers.

Oliver Fein, M.D., is president of Physicians for a National Health Program (www.pnhp.org) and professor of clinical medicine and clinical public health at Weill Cornell Medical College in New York City. He will be visiting Huntsville next weekend.

Healthcare Reform Schedule

Oliver Fein, president of Physicians for a National Health Program, will be the keynote speaker at healthcare reform events next weekend in Huntsville. Here is the lineup of presentations.

Saturday, Feb. 27, 1 – 3 p.m.“Point / Counterpoint: Fixing the American Health System”Physicians from opposite ends of the policy spectrum will present their solutions to our health care crisis. Dr. Oliver Fein, president of PNHP, will present the case for expanding and improving Medicare to all. Dr. Allan Goldstein, past president, Medical Society of the State of Alabama; and Alabama delegate to the American Medical Association, will focus on quality of healthcare as a way to reduce costs, and the reforms necessary to reach that goal.Location: Crestwood Medical Center, One Hospital Drive, Huntsville. First floor auditorium.

All three events are FREE and open to the public.For more information, visit http://northalabamahealthcareforall.org/